Reply With QuoteSo the government ordered from Turkey then. That went well.Originally Posted by TBKBABAB
Good for the charities, I said it may have happened that some companies were supplying care homes.
There is a full assessment required before they can approve suppliers if its to be used as frontline PPE in the NHS
and probably those companies couldn’t wait nor could the NHS.
Last edited by TBKBABAB; 14th May 2020 at 11:37.
So the government ordered from Turkey then. That went well.
'Against stupidity, the gods themselves struggle in vain' - Schiller.
We were talking about current infections and their relevance to R, not total of people who had had it which
is what the Spanish report says.
Don’t think I was the one who first mentioned Turkey, I was just replying to someone using that as a rather ridiculous point of reference.
Not in the post I quoted. I am the one who just mentioned Turkey in this development of the thread.
You were suggesting that meeting standards was too much of a faff for UK companies, despite the fact that they manage to supply other countries in the EU (where the standards are, in all probability, similar as a few weeks ago this country was still part of it.
'Against stupidity, the gods themselves struggle in vain' - Schiller.
I think that it is a little unfair to criticise the Government or the PHE for the problems with PPE.
Public Health England (PHE) is not and never has been responsible for the procurement of goods (such as PPE) within the NHS. PHE is a health promotion agency and its only role in relation to PPE is to issue guidance on who should wear it and I think it also has a responsibility to maintain the national pandemic stockpile.
Responsibility for procuring PPE rests with the NHS itself through the NHS Supply Chain - it used to be the NHS Logistics Agency which merged into the NHS Business Services Authority and then in 2018 a new organisation called the NHS Supply Chain was set up to handle all aspects of procuring goods within the NHS:
"NHS Supply Chain manages the sourcing, delivery and supply of healthcare products, services and food for NHS trusts and healthcare organisations across England and Wales.
Managing more than 4.5 million orders per year, across 94,000 order points and 15,000 locations, NHS Supply Chain systems consolidate orders from over 800 suppliers, saving trusts time and money and removing duplication of overlapping contracts.
Lord Carter’s report into efficiency and productivity in the NHS, published in 2015, identified unwarranted variation in procurement across the NHS, resulting in the need to improve operational efficiencies to transform a fragmented procurement landscape. To undertake this transformation the Department of Health and Social Care established the Procurement Transformation Programme (PTP) to deliver a new NHS Supply Chain.
The new NHS Supply Chain was designed to help the NHS deliver clinically assured, quality products at the best value, through a range of specialist buying functions. Its aim is to leverage the buying power of the NHS to negotiate the best deals from suppliers and deliver savings of £2.4 billion back into NHS frontline services by the end of the financial year 2022/23."
No one disputes that there have been serious difficulties with PPE but that is not necessarily anyone's fault. As the Institute of Government has pointed out:
"The UK’s national pandemic stockpile was designed to respond to an outbreak of pandemic influenza and, as such, it was ready to supply around 200 NHS trusts with protective equipment, rather than the over 50,000 NHS providers, GP surgeries, care homes and hospices that have required it in recent weeks"
However, if there is a failure in the procurement of PPE then, as per the above, it is surely an operational failure by the NHS to protect NHS workers and others. This is not a popular message to a public that has put the NHS on such a pedestal but failings on the part of some NHS workers may therefore have led to the deaths of other NHS/care workers.
Of course, a Minister is accountable for everything that happens within his or her Department but it is unreasonable to expect them to actively get involved in buying or supplying PPE - surely they have to be able to rely on the competence of the NHS staff in the various agencies/hospitals etc. under them?
It's my understanding from the reporting I saw Govt took some weeks to respond to those initial approaches by businesses and then those were only automated acknowledgements of receipt of message, time passed nothing further from Govt...time was wasted, from the start the WHO stressed again and again how critical it was to waste not a minute otherwise you end up behind the curve with Covid. And then Turkey, for heavens sake.
The facts, reality of where the UK is now, speak for themselves.
Im not blaming anyone but I understood that in situations like a pandemic then in order to coordinate supplies and to
stop Trusts competing to buy the same PPE that NHE took over the procurement role.
Over the last couple of decades or so, a mindset seems to have developed that all bad things that happen are somehow the governments fault. Some of them will be, some may not be. It is also common to judge with the benefit of hindsight without being full aware of the circumstances decisions were made in. My personal feeling is that one dimensional, race to the bottom, intellectually slack journalism is at least partly to blame for these trends.
Now if an opportunity to procure PPE was lost because of a direct political intervention then that's another matter entirely.
Last edited by Jeremy67; 14th May 2020 at 13:26.
I am not belittling the efforts or help offered by these small companies but there must have been a great need to
prioritise who and what to reply to when every department of the civil service must have been
under huge strain so someone saying they could maybe make a 100 gowns a week probably didn’t get a phone
call back. And the logistics of trying to organise this with smaller suppliers probably meant it wasn’t going to
be a viable option, the figure being banded about was 150,000 gowns a day so realistically it probably made
a lot more sense to put all your time and effort into trying to secure them from major suppliers.
You're suggesting that this whole expedition to Turkey, with a dedicated RAF plane, taking over a week from take off to return, was only for under 3 day's worth of gowns?
'Against stupidity, the gods themselves struggle in vain' - Schiller.
My response to passenger probably covers this, but I didn’t say it was a faff and they may well have sold to private companies
in Europe.
I Can’t see that I mentioned or suggested anything about Turkey.
Yes it is terrible that NHS staff died, and I have every sympathy for anyone who has lost a relative or loved one. But the question is whether they died because of a lack of PPE.
An alternative view from someone directly involved.
https://www.lincolnshirelive.co.uk/n...pitals-4060924
Last edited by oldoakknives; 14th May 2020 at 12:16.
Started out with nothing. Still have most of it left.
On balance Rod do you think they have been more ‘right’ than us or not?
You’re transparent and looking for an argument. You rephrased my comments into something I didn’t say, in the hope of continuing to argue it. You seem to enjoy debate for the sake of it. Which is fine, if that’s who you are and it’s your preferred hobby. I just hope you add something positive to society when not doing it.
I am not sure where you get the figures so I'll accept them for what they are. I'll just point out that if those companies can supply other countries in the EU they probably had the capacity to supply at least a few trust's worth of equipment. That I have no doubt the NHS had a long list of suppliers (the cheaper ones, for better or for worse) from abroad. Unfortunately the delays in taking the measure of Covid meant that by the time they ordered more PPE they were at the back of the queue (why does that sound familiar?) and had to find other untested suppliers, thus having to first validate that the product met standards (more delays) and then fly to and bring back 3 days worth after a week in waiting. It seems to me -but maybe it's me- that their time would have been better spent ordering from 100 companies, may be many local to the EU.
'Against stupidity, the gods themselves struggle in vain' - Schiller.
I think we can blame the government. I know someone who was able to provide 2 million face masks months ago, and is still waiting for the Govt to decide. They were also able to supply respirators made to order, and again waited indefinitely for an answer. And they are all at approved standards.
Makes no sense. But then again, I can't say I've been impressed by any of the politicians thus far. Had the scientists been in charge we might have had a different outcome. Reminds me in some ways of the Iraq dossier. Government interprets facts and acts as it seems fit.
With respect, it's a cop out:
I don't believe that the WHO or the Royal Colleges were consulted for the revision.He went on to say: "We understand that some members of staff do not agree with what the national guidance says, but we are bound by this guidance, which has been endorsed by the World Health Organisation (WHO), the Health and Safety Executive (HSE) and the Royal Collages."
'Against stupidity, the gods themselves struggle in vain' - Schiller.
Can't recall the Dr's name now, Asian chap on the frontlines, anyway this gentleman wrote to Johnson literally begging him to sort out the supply of PPE for his colleagues as there wasn't enough for everyone, he contracted Covid and sadly died a couple of weeks later. Perhaps he was making it up.
Doesn't it seem more likely on the balance of probabilities if you're working daily in a covid rich environment, then that's where you'll catch it...particularly so if you're short the correct PPE or it's had to be cleaned/reused...
I don’t want a argument but if you post things on an open forum apparently making statements which are in fact
only your opinion you shouldn’t be surprised if someone points this out. If you say it’s your opinion you may also get replies
but you can’t expect everyone to agree with you.
And then you replied saying I had posted a question which I hadn’t and I just pointed that out. If you don’t want an argument then don’t reply. Posting rather nasty judgements on people you don’t know is also not exactly the response of someone
who doesn’t want an argument either.
On balance yes, they are years ahead of us with tech and more importantly discipline.
Maybe some of the preparation is because of the threat from North Korea.
Exactly, the public fetishisation of the NHS is not a healthy state of affairs and hasn't been for a long, long time.
As someone who works in the NHS I think it would be better to fund it appropriately rather than have a couple of minutes of clapping tonight. There's a collective fantasy that it can do no wrong but it continues to treat some of its staff groups quite appallingly, particularly its junior medical staff. When this is over there will be a reckoning over PPE and it won't just be the politicians who will have questions to answer.
I can see how it appears nasty but it wasn't meant to be. The last thing I want to do at the moment is make someone feel bad. You don't seem nasty in your replies, but you did suggest I made an argument I didn't. Probably unintentionally though.
With respect it isn't a cop out. You picked a small part to highlight. Here's another part of what he said.......
Referring to the guidance issued on Friday stating that staff could be asked to re-use some items of PPE if stocks run low, Mr Morgan said he would expect this to be issued in circumstances like this.
"To be clear, our stocks locally are at a good level," he wrote. "However, we are enacting contingency planning for our gowns, as other organisations are.
"We are now following the new guidance and asking critical care and ED teams to bag their PPE gowns after use in a tiger stripe bag, placed inside a clear bag, ready for decontamination.
"This new national guidance was shared with staff yesterday as part of the SBAR in the interests of being open and transparent and it appears this has caused unnecessary concern and alarm, for which we would like to apologise.
"To be clear, we do not have any immediate shortages of any PPE within ULHT. But the new guidance is in place in the event that we do."
https://www.lincolnshirelive.co.uk/n...pitals-4060924
And my opriginal question still stands. How many hospitals actually ran out of PPE?
Last edited by oldoakknives; 14th May 2020 at 13:11.
Started out with nothing. Still have most of it left.
Discipline probably but also they don’t have any choice about the government using info from their phones,
believe that they have written into law that in certain circumstances including major health issues the
government have the right to access it. You can of course leave your phone at home.
Waiting for the debate to start when the tracking app gets released here.
South Korea, Taiwan etc. are so far ahead of us because they went through the same thing with SARs a few years back. In this interview, one of South Korea's top experts implies that you can't really be prepared for a Pandemic unless you have had one before (minutes 19 to 22 below). SARs hammered South Korea, Taiwan, Singapore and Hong Kong, all the countries that have handled Covid-19 really well - they learned lessons.
https://www.youtube.com/watch?v=gAk7aX5hksU
OK let’s let it go, but one thing that does annoy me (and maybe I react too much to this) is when people post things as though it is a statement of fact or use the one I really don’t like ‘nobody’ when it’s just their opinion which comes across to me as trying to intimidate.
The other problem is something I found really annoying when at work we switched to Skype for a lot of
comms (not video) one persons interpretation of what you have typed can be different to yours,
especially as you tend to type how you speak but of course with no inflection.
So based on their experience of SARS and MIRS, and "lessons learned', we have no excuse for being so unprepared. But then again, our fate, like the US, was in the hands of a buffoon.
There are exceptions: the PPE that is specifically 'single-use only', but which miraculously turned into 'wash and re-use' when the stocks ran low.
R
Ignorance breeds Fear. Fear breeds Hatred. Hatred breeds Ignorance. Break the chain.
Hadn’t heard of single use PPE being reused.
Any evidence on how much it happened?
Last edited by oldoakknives; 14th May 2020 at 13:59.
The figures were those used at the time everyone was constantly questioning the government about PPE supply.
I don’t think price was the driving issue or that they bought the cheapest more those that could do volume, not
sure the full story on the Turkish shipment came out, it definitely wasn’t 400,000 gowns didn’t comply as
400,000 weren’t sent in that shipment, but from what was sent most actually were OK and the Turkish
government sent additional ones to make up some of the shortfall. The Turks actually had a ban on exports of PPE
but agreed to the shipments so I guess the government didn’t want to annoy them too much so happy to let it
go quiet on this front.
No, what he means is that this is our first Pandemic so the NHS will be ready for the next one!
I think we can too but there seems to be a few Gov apologists on this thread.
This is a failure of leadership. The Gov has all the machinery of government and the finances of the fifth (or is it sixth) richest country in the world to mount a planned & coordinated strategy drawing on its vast resources, and failed. They have the benefits of socialised healthcare, the advantage of time & opportunity to learn and adopt best practice from other countries who went into this pandemic before us, expert advice from the WHO and CDC, experts of all sorts from the UK's academia and science community, expertise and global experience gained from managing Ebola/SARS/MERS/Mad Cow and other pandemics, favourable employment practices, a large civil service etc etc and squandered all of it through piss poor preparation, planning and coordination. It seems to have been a lazy, heavily politicised approach born from a belief that the UK would do better than Italy, because we are the UK. Furthermore, this failure of leadership has led to the four nation states managing the lockdown differently which hints at the Gov not consulting and collaborating effectively or drawing upon the knowledge, ideas and collective wisdom of the country's four nations leadership to plan strategy and response.
Then they obfusicate and lie to us constantly. Hardly a way to instill trust and cohesion for the greater good across society. A second wave is inevtiable which terrifies me because that is when deep and irreparable damage will be done to our country and the fabric of society. Why are we easing lockdown without more testing, track & trace, a reliable APP, stopping all incoming flights unless arrivals go into 14 days Gov quarantine or enforcing PPE use more widely?
There has been much written in the press and discussed on TZ regarding the pathetic management of PPE procurement, ignoring of UK companys offers to assist, contracts being awarded to Gov supporter etc, but out of all of this gross incompetence and politicing, the care home crisis is the most damning. But I see excuses being offered up for that too.
(I realise this post is political but then so is most of this thread, it pribably should be in the Bearpit)
[QUOTE=mondie;5415714] expert advice from the WHO and CDC/QUOTE]
Expert advice from the WHO and CDC - really!!?
https://www.newstatesman.com/world/a...avirus-cost-us
The WHO was telling Govs globally what they should do to prepare but the UK ignored it. If there is any truth in the article you posted that is a serious, but separate issue to ignoring the WHO and doesn't invalidate what they have been saying since January.
Yes let’s learn from that, put down anyone who is infected and anyone who lives with them.
WHO say self distancing should be 1 metre, don’t see anyone suggesting we use that, you can pick and choose which bits you believe from lots of different sources but the truth is no body knew or knows exactly what the best strategy is/was 100%.
Last edited by TBKBABAB; 14th May 2020 at 15:30.
We have the NHS we can afford and I think going forward the NHS is never going to be as well funded as it is at the moment. Its going to take a lot of years of austerity to get us back to the poor state of affairs we were at the beginning part of the year
It is about science, not belief. The WHO is not just another bunch of scientists with an opinion, it is a large well-funded organisation with global reach and representation and has hundreds of experts in all areas of medical science all working to evaluate evidence and provide current best practice advice.
It’s less about how well the NHS is funded rather more about well it’s lead, managed and governed. You can throw all the money you want at something, but unless the right people are in place, you may as well set fire to the cash.
Just imagine what good management and more cash freed up by cancelling the vanity project of HS2 would do for the NHS, education and the emergency services.
Sent from my iPhone using TZ-UK mobile app
Why did the WHO state in January 2020 that Covid-19 was not capable of human to human transmission?
Why, when first Italy and then the USA banned flights in February, did the Director-General of WHO warn that this would “have the effect of increasing fear and stigma, with little public health benefit. Using the word pandemic carelessly has no tangible benefit, but it does have significant risk in terms of amplifying unnecessary and unjustified fear and stigma, and paralysing systems. It may also signal that we can no longer contain the virus, which is not true.”
Why did the WHO not declare Covid-19 a pandemic until 11 March?
Yes, the WHO has hundreds of experts in all areas of medical science but if your leaders are in the pocket of China and every statement has to be vetted by China, it counts for nothing.
Just for balance, some of the best Chief Executives and Finance Directors that I have ever worked with, worked within the NHS. I wouldn't do their job for any amount of money!
I fully acknowledge and appreciate that. “Some”, but just not enough.
Sent from my iPhone using TZ-UK mobile app
There's a lot of overpaid management and underpaid front line workers in the NHS.
I've a friend in charge of a Trust, he once told me, his wage was obscene for what he did.
The other issue is massive losses through theft and bad management by successive Governments.
If they had procured the PPE before hand (and it's their duty to buy it and provide it),
maybe we would have been better prepared.
Instead it's one big mess, and folks blaming whoever, like in this thread.
No, I don’t know how much it happened.
What I do know is the government changed the HSE guidance over single use equipment to multi-use due to supply shortages.
R
Ignorance breeds Fear. Fear breeds Hatred. Hatred breeds Ignorance. Break the chain.
Oh I see. So it was changed to allow it in case it was required. I presume some of the equipment would lend itself to be cleaned and re-used, some not.
Started out with nothing. Still have most of it left.
Plus the £2bn of negligence claims per year
Indeed, some of the equipment would lend itself to be cleaned and re-used, some not - the latter are designated single use only and therefore not to be reused/reprocessed. Scotland, Wales and Northern Ireland continue to abide by this, but not England.
R
Ignorance breeds Fear. Fear breeds Hatred. Hatred breeds Ignorance. Break the chain.
Rod
The problem is that the public and the press would never have tolerated a situation where our Government spent tens of billions of pounds to prepare for something that may or may not ever happen. This was demonstrated in France where some poor Minister got slaughtered for preparing for a Pandemic that did not happen in good time:
From Le Monde:
Alarmed by another classified report, exhumed by Le Monde’s investigators, which warned that France was woefully unprepared for a pandemic, Douste-Blazy’s successor at the health ministry, Xavier Bertrand, set off on a tour of East Asian countries in late 2005 to learn from their strategies. Calling in Beijing, he asked his Chinese counterpart whether France could order masks from China in the event of a crisis. Though affirmative, the answer cautioned that “Chinese demands would naturally come first” should the country need masks too.
Convinced of the need to strengthen France’s strategic independence, Bertrand and his successors would embark on a vast effort to make the country pandemic-proof and self-reliant – a strategy that spanned the final years of Jacques Chirac’s presidency and the start of Nicolas Sarkozy's tenure.
A cornerstone of the new strategy was the establishment of a national mask-production capacity, overseen and generously funded by a new entity, known as the Eprus, modelled on the US Centers for Disease Control and prevention (CDC).
At the end of 2006, France could boast of a stock of 600 million FFP2 masks, making it one of the world’s best prepared countries, according to the World Health Organization. By May 2009, a Senate report said the Eprus stock had reached more than 720 million units, supplemented by more than a billion surgical masks.
It was just as well, because a new deadly epidemic, this one coming from Mexico, was about to test the arsenal’s worth.
Crying wolf
The French government’s zealous response to the H1N1 influenza marked the climax of the precautionary approach championed by Douste-Blazy and his successors. But in hindsight, it also sounded its death knell.
As the influenza spread beyond Mexico in the summer of 2009, the new health minister, Roseline Bachelot, decided to further ramp up the production of masks, leading to a peak of 2.2 billion units (surgical and FFP2) by the end of the year. Under government guidelines, businesses were advised to constitute stocks of protective gear, including the high-protection FFP2 masks for workers “in close contact with members of the public”. Kits containing surgical masks and antiviral treatments were distributed freely in pharmacies across France.
Controversially, the government ordered 94 million vaccine doses and requisitioned gymnasiums for its nationwide vaccination campaign, bypassing doctors.
But the health crisis failed to materialise, and when state auditors, politicians and the media started to delve into the cost of the operation, Bachelot was lambasted for splashing out a whopping one billion euros in taxpayers’ money – part of it to reimburse pharmaceutical labs – on a virus that killed “only” 342 people in France.
“When dealing with epidemics, one is easily accused after the facts of having botched the response,” says Geoffard of the Paris School of Economics. “Either one does too much prevention and little happens, or one does too little and everything goes wrong.”
According to Geoffard, the H1N1 backlash was “one of the key reasons it later became impossible to justify maintaining a highly costly prevention policy.”
Reflecting on her public castigation, Bachelot told Le Monde that the debacle had “led to a general disarmament and decrediblised politicians.” She added: “The public decided we had overreacted. And for us politicians, the risk of doing too much came to dwarf that of doing too little.”
So perhaps, we (the public) and the Press have to shoulder some of the blame as well. I can imagine several TZ-UK posters lambasting any Minister who did the above - "do you know how many doctors, nurses, teachers, we could have had for that money...and where is this mysterious Pandemic anyway?"
As I said in an earlier post, it is only when you get hit by a Pandemic that everyone agrees that you need to spend big to prepare for the next one!
A measured review after this is over will highlight where we could have done things better. It is just that currently there are too many smart asses in the media and elsewhere critiquing every decision taken with the benefit of 20:20 hindsight.
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